Hospitals Try Giving Patients a Dose of VR
Hospitals Try Giving Patients a Dose of VR
With the price of hardware falling, VR equipment has
become a more affordable option for doctors
By Ian King
Caroline Chen August 29, 2016 — 4:00 AM PDT
VR Movies Could Be Coming Soon to a Hospital Near You
When Deona Duke woke up from a medically-induced coma to
begin recovering from burns that covered almost a third of her body, one of her
treatments was hurling snowballs at penguins. The 13-year-old was set on fire
when a bonfire exploded on her and her friend. To prevent infection, burn
victims need their bandages changed and dead skin scraped away. Sometimes, even
morphine isn’t enough to make that tolerable.
At the Shriners Hospital for Children in Galveston,
Duke’s doctors gave her a virtual reality headset. Slipping it on, she was
immersed in “SnowWorld,” an icy landscape where she got to lob snow at snowmen
and igloos. The Texas hospital is one of the few trying out virtual reality to
relieve pain.
“I’d never heard of it so I was a little surprised,” she
said. “When I first tried it, it distracted me from what they were doing so it
helped with the pain.”
It’s still a new and experimental approach, but
proponents of virtual reality say that it can be an effective treatment for
everything from intense pain to Alzheimer’s disease to arachnophobia to
depression. And as Facebook Inc., Sony Corp., HTC Corp. and others race to
build a dominant VR set, the price of hardware has fallen, making the equipment
a more affordable option for hospitals looking for alternatives for pain
relief.
The idea is that the worst pain can be alleviated by
manipulating the way the human mind works: the more you focus on pain, the
worse it feels. Swamp the brain with an overload of sensory inputs—such as with
the immersion in a virtual world—and its capacity to process pain, to be
conscious of it, goes down.
“Pain is our harm alarm and it does a really good job of
getting our attention,” said Beth Darnall, a clinical associate professor at
Stanford Health Care’s division of pain medicine. She says VR, which Stanford
has done some pilot studies on, is a psychological tool, like meditation, that
can “calm the nervous system, and that dampens the pain processing.”
In research done at Shriners by psychologists Hunter
Hoffman and Walter Meyer, and similar work done by Dave Patterson at Harborview
Burn Center in Seattle, patients reported less discomfort. Hoffman examined
magnetic resonance imaging (MRI) scans of patients’ brains, which showed they
actually experienced less pain.
“I was very surprised by it. I didn’t have the
expectation of it working.”
At Cedars-Sinai in Los Angeles, Ronald Yarbrough is
waiting in a room that overlooks the hospital’s landing pad, hoping to see
helicopter bring him a donor heart. He needs a transplant after his artificial
one failed and is being kept alive by a machine. He has been trying a Samsung
Gear VR headset and specially created software from a startup called AppliedVR.
It helped take his mind off the fact that he’s confined to a small hospital room
that can feel like a jail cell. When his muscles relaxed, his pain receded, he
said.
“I was on a lot of pain medication and I’ve been able to
whittle that down because I’m not sitting around thinking about it,” said the
54-year-old former truck driver. He intends to buy a VR headset when he’s
discharged. “I was very surprised by it. I didn’t have the expectation of it
working. When I got into it, I was amazed.”
Proponents of VR are quick to point out that it could
have a big benefit over drugs, which can lead to tolerance over prolonged use
and sometimes addiction. But VR’s effectiveness still has to be proven,
particularly when trying to combat chronic pain. Does the effect last when the
headset comes off?
“We know that relaxation techniques like hypnosis, yoga,
and meditation decrease your perception of pain, so VR has a lot of promise,
but it’s too early for it to be the standard of care,” said Houman Danesh,
director of integrative pain management at Mount Sinai Hospital in New York.
“It’s a very young technology.”
There’s a lot more research needed before VR is going to
be widely accepted as a pain relief method. Brennan Spiegel, a
gastroenterologist at Cedars-Sinai who’s also director of health services
research at the Los Angeles hospital, is about to begin a study on many more patients.
So far he’s experienced a range of reactions. Older patients tend to be less
open to it than younger ones. One terminal patient refused to even consider it.
One woman, who suffered abdominal pain, got such immediate relief that she went
home and bought herself a headset.
The price of a headset and software is tiny compared to
the expense of keeping a patient in the hospital for an extra day.
“As a scientist, I want to understand rigorously how
something like virtual reality can truly improve health outcomes compared to a
control population,” said Spiegel who said he’s seen some amazing results in
the 150 or so patients he’s tried it on. “Virtual reality undoubtedly has an
effect on the human mind.”
VR’s potential for use in pain management was discovered
by accident. Tom Furness is a professor of industrial engineering at the
University of Washington and considered to be the godfather of VR by his peers.
He started looking into VR 50 years ago when he was in the Air Force, and has
spun off more than 20 research projects into companies. One of them was a 1993
consumer headset that relied on a TV tuner and video tapes that sold for $799.
It was a commercial flop because of the limited content, but a lot of dentists
bought it.
“The dentists loved it because their patients weren’t
complaining,” he said. The experience distracted children from their fear of
injections, drilling and fillings.
That aha moment led to more research into the long-known
phenomena of distraction and meditation as techniques to relieve pain. But just
like Furness’ attempt to bring VR to the masses, it was held up by costs. Early
VR equipment for medical use cost as much as $35,000 for a headset, said Hunter
Hoffman, who studied with Furness at the University of Washington.
That’s all set to change this year. VR is graduating from
geeky sideshow to big business and equipment prices are dropping. Oculus Rift
Headset retails at $599. HTC’s Vive costs $799. To get them to work, you’ll
need a PC that costs about $999 to run the software. The market’s going to
continue to expand as Sony adds the capability to their game consoles and
smartphone makers upgrade their technology to get closer to the kind of
performance needed to provide an effective VR experience.
The economics may make VR an attractive experiment for
some hospitals. Hospital care takes up to about 30 percent of the U.S.’s annual
$3 trillion in health-care spending, making it the most costly category of
treatment. The price of a headset and software is tiny compared to the expense
of keeping a patient in the hospital for an extra day. So if there’s a chance
that VR could lead to an early discharge, it may make sense for a hospital to
spend on the hardware, said Cedars-Sinai’s Spiegel.
Companies such as AppliedVR are already trying to make
the distribution and development of the technology into a business. They’re
supplying hospitals with the headsets and therapeutic software. Another
startup, DeepStream VR, is also working on software and systems that help
patients with burns and other injuries. Its ‘Cool!’ software features the
adventures of an otter.
They may have some work to do to keep patients
interested. The VR made her feel better, but Duke quickly got bored with
SnowWorld, and that diminished the painkilling effect.
“For teenagers they should find, like, different games,”
she said. “That game they were showing me seemed like it was for little kids.”
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